MEDICARE: NEW LIFECARE HOSPITALS OF NORTH TEXAS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	100117	TX
2	282E00000X	Long Term Care Hospital	100117	TX

General Provider Information

NPI Number	:	1023451077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFECARE HOSPITALS OF NORTH TEXAS LLC

Provider Business Mailing Address
First Line	:	5340 LEGACY DR
Second Line	:	SUITE 150
City	:	PLANO
State	:	TX
Zip	:	75024-3178
Country	:	US
Telephone Number	:	469-241-2128
Fax Number	:	469-241-2177

Provider Business Practice Location Address
First Line	:	1950 RECORD CROSSING RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6223
Country	:	US
Telephone Number	:	214-640-9600
Fax Number	:	214-640-9654

Authorized Official
Title or Position	:	VICE PRESIDENT - REIMBURSEMENT
Name	:	MR. MICHAEL CRONIN
Credential	:
Telephone Number	:	469-241-2128

Provider Enumeration Date	:	04/09/2013
Last Update Date	:	05/28/2015

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